Baylor College of Medicine is an ideal site for the Tuberculosis Academic ward because many of the patients it serves are at risk for tuberculosis, its faculty and institutions care for hundreds of tuberculosis patients each year, It has commitment to curriculum change in public health, and it has strong associations with community agencies involved in tuberculosis. This curriculum plan will emphasize acquisition of knowledge, positive attitudes and skills about tuberculosis and related public health issues. Curriculum development will be directed by a Curriculum Committee; an Advisory Board will implement and diffuse the curriculum throughout the College. A new annual tuberculin screening program for students, residents, and faculty will provide a focal point for assessment and education by stressing personal health considerations. The curriculum for a Tuberculosis and Public Health Scholars Program will be developed by experts in tuberculosis, public health, community medicine, social and behavioral medicine, and medical education. Participants in this program will be faculty with either expertise in tuberculosis and public health, or significant primary care teaching responsibilities. This Program will "train the trainers" who can diffuse their knowledge into the programs and curricula of their departments. Emphasis will be placed on diagnosis, treatment and prevention of tuberculosis; public health and health promotion; risk factor assessment; patient adherence; infection control practices; HIV-related diseases; and ethnic and cultural influences on health behavior. The curricula for students and residents will be scrutinized to identify current and new opportunities for diffusion of this expertise. Measures of impact will include surveys, interviews, chart reviews of tuberculosis patients, and skin test conversion rates among students, residents and faculty. Research will assess the knowledge and attitudes of healthcare workers before and after interventions and will determine high-risk patients' perspectives on barriers to their diagnosis and treatment at Baylor and other community facilities. A survey of community physicians who have or have not recently reported cases of tuberculosis or AIDS will be conducted. Methods will be developed to deliver the curriculum to community physicians by a Community Advisory Group. Dr. Jeffrey Starke, principal investigator, has extensive expertise in tuberculosis, public health, and medical school curricula. Dr. Ronald Lorimor will collaborate in the development of survey instruments and data bases. An additional 29 experts will serve on the project committees.